JAMA:阿帕西普vs手术治疗增生性糖尿病视网膜病变导致的玻璃体出血视力损伤

2020-12-19 MedSci原创 MedSci原创

对于增生性糖尿病视网膜病变导致的玻璃体出血视力损伤患者,初始治疗方案选择玻璃体内注射阿帕西普或玻璃体切除联合视网膜光凝治疗对24周的字母视力评分影响差异不显著

增殖性糖尿病视网膜病变是一种常见的糖尿病并发症,由于高血糖对视网膜血管损害造成的组织缺血、缺氧,出于代偿作用,机体长出新生血管供血,进而会出现增殖改变,严重可导致玻璃体出血和视力丧失。近日研究人员比较了玻璃体内注射阿帕西普与玻璃体切除联合视网膜光凝治疗增殖性糖尿病视网膜病变玻璃体出血的疗效差异。
 
研究在美国和加拿大开展,包含205名成年增生性糖尿病视网膜病变导致的玻璃体出血视力损伤患者,每名参与者1只眼睛参与研究,100名参与者接受阿帕西普治疗,每4个月1次。105名参与者接受玻璃体切除联合视网膜光凝治疗。研究的主要终点是24周的平均字母视力评分(0-100),组间差异在8字母以上认为存在显著差异,次要终点为4周和2年的平均视敏度等。
 
参与者平均年龄57岁,男性占56%,基线平均字母视力评分34.5,95%的参与者完成24周研究。阿帕西普组24周平均字母视力评分为59.3,而玻璃体切除联合视网膜光凝治疗组为63.0,差异为-5。23项次要终点中,15项无显著差异,包括4周(差异为-11.2)和2年(差异为2.7)的平均视敏度评估。2年后,阿帕西普33名患者(33%)接受了玻璃体切除联合视网膜光凝治疗,而玻璃体切除联合视网膜光凝治疗组34名(32%)患者接受了阿帕西普治疗。
 
研究认为,对于增生性糖尿病视网膜病变导致的玻璃体出血视力损伤患者,初始治疗方案选择玻璃体内注射阿帕西普或玻璃体切除联合视网膜光凝治疗对24周的字母视力评分影响差异不显著。
 
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    2021-02-01 6322400001

    学习了

    0

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    2020-12-21 zutt
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    2020-12-19 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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    2020-12-19 misszhang

    谢谢MedSci提供最新的资讯

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